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Unwanted and leftover pharmaceuticals are a complex waste stream that poses many health, safety and environmental risks, including drug overdoses, drug abuse, poisonings and water pollution.
For details on safe disposal, see:
- How to safely dispose of household pharmaceutical waste
- Safe disposal of non-household pharmaceutical waste
Problem and solutions
Defining the problem
Every year across the United States, prescription and over-the-counter drugs of all types are manufactured, marketed, prescribed, dispensed and discarded at extraordinary rates. In Wisconsin, it is estimated that nearly 120 million prescriptions for pharmaceuticals are sold each year, and roughly one-third of all doses prescribed go unused. This often leads to an accumulation of unused medicines in the household, which puts human and animal health at risk due to accidental ingestion, overdose, or abuse. In fact, according to the Centers for Disease Control and Prevention, unintentional prescription opioid overdoses now kill more Americans than cocaine and heroin combined.
For information about how prescription drug abuse affects Wisconsin and what can be done about it, see the State Council on Alcohol and Other Drug Abuse's January 2012 report, Reducing Wisconsin's Prescription Drug Abuse: A Call to Action.
If not stored or abused, drugs are usually flushed down the drain or thrown out with the trash - both of which may lead to surface water contamination and toxicity to fish and wildlife.
While no studies to date have definitively demonstrated harmful effects on human health from long-term exposure to trace amounts of active pharmaceutical ingredients - such as through drinking water - studies have found pharmaceuticals present in some ecosystems at levels likely to harm entire populations of aquatic organisms.
To combat the growing problems of prescription drug abuse and environmental pollution, communities throughout Wisconsin have created and implemented voluntary household drug take-back programs. In 2011, approximately 93,500 pounds of household pharmaceuticals were safely collected in Wisconsin through a mix of mail-back and one-day and permanent drop-off collection programs. Response to these programs has been extremely positive, with strong support from citizens, law enforcement, pharmacists and health care professionals.
Yet despite Wisconsin's best efforts, current collection options are insufficient and unsustainable. They have high per capita operation costs, which fall primarily on local governments already challenged by tight budgets, while only collecting about two percent of available unused drugs.
DNR study on household pharmaceutical waste
In 2012, the DNR contracted with UW-Extension and the Product Stewardship Institute to conduct an in-depth assessment of the full costs, benefits, opportunities and challenges to expanding household take-back programs that provide healthier and safer alternatives to landfill and sewer disposal. Additionally, the study collected data to establish a baseline collection rate against which future programs can be measured. The study also used these data to compare costs associated with current take-back programs with alternative collection and disposal approaches found in Canada and Europe.
Key findings of the report include the following.
- Only 2 percent of the total amount of unused household pharmaceuticals was collected for safe disposal in 2011, despite significant voluntary collection efforts around the state.
- The estimated cost of Wisconsin take-back programs ranges from $8.05 to $10.07 per pound. By comparison, producer-managed programs in Canada and France average $3.50 per pound and $0.23 per pound, respectively.
- Barriers to effective collection programs include high costs, lack of sustainable funding, consumer inconvenience, low public awareness and inadequate program promotion. Limited in-state capacity for pharmaceutical destruction also contributes to high program costs.
The study recommends exploration of solutions, such as:
- creating a dense network of pharmaceutical waste drop-off locations providing free and easy access to citizens;
- widely promoting those collections;
- monitoring and evaluating pharmaceutical waste generation and collection rates;
- securing consistent funding from a reliable source; and
- adopting regulatory changes to facilitate transportation and reduce costs of collection and safe disposal.
Results from the study will be used to identify acceptable short-term solutions and to seek convenient and sustainable longer-term solutions to the problems posed by unwanted pharmaceuticals.
The DNR collaborates on an ongoing basis with a broad group of stakeholders to identify and evaluate sustainable, environmentally responsible ways to manage waste pharmaceuticals. The DNR is a coordinating partner in a U.S. Environmental Protection Agency-funded Great Lakes Restoration Initiative grant aimed at keeping pharmaceutical compounds out of the Great Lakes. Learn more about this project.
The DNR and the UW-Extension Solid and Hazardous Waste Education Center co-chair the Wisconsin Pharmaceutical Waste Working Group to reduce the effects of pharmaceutical waste on Wisconsin's environment and communities. This group of diverse stakeholders recommended several actions to improve prescription drug disposal to the Wisconsin State Council on Alcohol and Other Drug Abuse for its 2012 report Reducing Wisconsin's Prescription Drug Abuse: A Call to Action.
In May 2012, the working group, the DNR and the Pharmacy Society of Wisconsin partnered to develop a flier that PSW distributed to its member pharmacies to help their customers manage and reduce pharmaceutical waste. Other subgroups of the working group are finding ways to destroy collected pharmaceuticals within Wisconsin and to reduce pharmaceutical waste in both households and health care facilities.